{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:16:16Z","timestamp":1790507776979,"version":"4.1.0"},"reference-count":57,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:p>Women with hereditary non-polyposis colorectal cancer (HNPCC)\/Lynch syndrome have a high risk for endometrial cancer (EC) and frequently present with a gynaecological cancer as their first or sentinel malignancy. Identification of these patients is important given their personal and family risk for synchronous and metachronous tumours. Modalities to detect ECs for the possibility of HNPCC include microsatellite instability assay, immunohistochemistry for DNA mismatch repair proteins, MLH1 promoter hypermethylation assay and mutational analysis of DNA mismatch repair genes. The revised Bethesda guidelines provide screening criteria for HNPCC in colorectal cancers (CRCs). However, there are currently no such screening recommendations for women with endometrial carcinoma. While age and family history are useful screening criteria, their sensitivity has been shown to be low for detection of HNPCC in EC. Expansion of these criteria to include tumour morphology (presence of tumour infiltrating lymphocytes and tumour heterogeneity including dedifferentiated\/undifferentiated ECs) and topography (lower uterine segment localisation) as well as presence of synchronous ovarian clear cell carcinomas may significantly enhance the detection of patients with EC at risk for HNPCC. Consideration should be given to incorporating these screening criteria into a revision of the Bethesda guidelines for detecting EC patients at highest risk for HNPCC.<\/jats:p>","DOI":"10.1136\/jcp.2009.064949","type":"journal-article","created":{"date-parts":[[2009,7,28]],"date-time":"2009-07-28T14:52:34Z","timestamp":1248792754000},"page":"679-684","source":"Crossref","is-referenced-by-count":109,"title":["Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma"],"prefix":"10.1136","volume":"62","author":[{"given":"K","family":"Garg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R A","family":"Soslow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,7,28]]},"reference":[{"key":"2025092505443873000_62.8.679.1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910460108"},{"key":"2025092505443873000_62.8.679.2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19990412)81:2<214::AID-IJC8>3.0.CO;2-L"},{"key":"2025092505443873000_62.8.679.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000154885.44002.ae"},{"key":"2025092505443873000_62.8.679.4","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-06-1114"},{"key":"2025092505443873000_62.8.679.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.06.055"},{"key":"2025092505443873000_62.8.679.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043146"},{"key":"2025092505443873000_62.8.679.7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.04.094"},{"key":"2025092505443873000_62.8.679.8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.10.8597"},{"key":"2025092505443873000_62.8.679.9","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197710)40:4+<1849::AID-CNCR2820400813>3.0.CO;2-U"},{"key":"2025092505443873000_62.8.679.10","first-page":"961","article-title":"Revised Bethesda guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability.","volume":"96","author":"Umar","year":"2004","journal-title":"J Natl Cancer Inst"},{"key":"2025092505443873000_62.8.679.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(00)70168-5"},{"key":"2025092505443873000_62.8.679.12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.13.4940"},{"key":"2025092505443873000_62.8.679.13","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31817051d9"},{"key":"2025092505443873000_62.8.679.14","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/ijc.22446","article-title":"Surveillance for endometrial cancer in hereditary nonpolyposis colorectal cancer syndrome.","volume":"120","author":"Renkonen-Sinisalo","year":"2006","journal-title":"Int J Cancer"},{"key":"2025092505443873000_62.8.679.15","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.38.5.318"},{"key":"2025092505443873000_62.8.679.16","doi-asserted-by":"publisher","DOI":"10.1086\/337944"},{"key":"2025092505443873000_62.8.679.17","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.05.036"},{"key":"2025092505443873000_62.8.679.18","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1030231100"},{"key":"2025092505443873000_62.8.679.19","doi-asserted-by":"publisher","DOI":"10.2353\/jmoldx.2008.080031"},{"key":"2025092505443873000_62.8.679.20","first-page":"5059","article-title":"Microsatellite instability: marker of a mutator phenotype in cancer.","volume":"54","author":"Loeb","year":"1994","journal-title":"Cancer Res"},{"key":"2025092505443873000_62.8.679.21","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1202178"},{"key":"2025092505443873000_62.8.679.22","first-page":"462","article-title":"Causes and consequences of microsatellite instability in endometrial carcinoma.","volume":"59","author":"Gurin","year":"1999","journal-title":"Cancer Res"},{"key":"2025092505443873000_62.8.679.23","first-page":"5248","article-title":"A National Cancer Institute workshop on microsatellite instability for cancer detection and familial predisposition: development of international criteria for the determination of microsatellite instability in colorectal cancer.","volume":"58","author":"Boland","year":"1998","journal-title":"Cancer Res"},{"key":"2025092505443873000_62.8.679.24","doi-asserted-by":"publisher","DOI":"10.1038\/onc.2008.217"},{"key":"2025092505443873000_62.8.679.25","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9896(2000)9999:9999<::AID-PATH701>3.0.CO;2-2"},{"key":"2025092505443873000_62.8.679.26","doi-asserted-by":"publisher","DOI":"10.1053\/hupa.2002.32220"},{"key":"2025092505443873000_62.8.679.27","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1155\/2004\/391039","article-title":"Identification of HNPCC by molecular analysis of colorectal and endometrial tumors.","volume":"20","author":"Vasen","year":"2004","journal-title":"Dis Markers"},{"key":"2025092505443873000_62.8.679.28","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000213428.61374.06"},{"key":"2025092505443873000_62.8.679.29","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21560"},{"key":"2025092505443873000_62.8.679.30","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.10429"},{"key":"2025092505443873000_62.8.679.31","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-1110-03"},{"key":"2025092505443873000_62.8.679.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2007.05.022"},{"key":"2025092505443873000_62.8.679.33","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318197a046"},{"key":"2025092505443873000_62.8.679.34","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000126720.49083.11"},{"key":"2025092505443873000_62.8.679.35","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-07-1849"},{"key":"2025092505443873000_62.8.679.36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1438.2006.00535.x"},{"key":"2025092505443873000_62.8.679.37","unstructured":"Toledo G Growdon WB Dias-Santagata D . Microsatellite instability status and clinicopathologic profile of endometrial cancer in young women. Abstract 1036. Mod Pathol 2008;21 (Suppl 1)."},{"key":"2025092505443873000_62.8.679.38","doi-asserted-by":"publisher","DOI":"10.1097\/01.pgp.0000183048.22588.18"},{"key":"2025092505443873000_62.8.679.39","first-page":"173A","article-title":"HNPCC-related endometrial carcinomas show a high frequency of non-endometrioid types and of high FIGO grade endometrioid carcinomas. Abstract 801.","volume":"19","author":"Carcangiu","year":"2006","journal-title":"Mod Pathol"},{"key":"2025092505443873000_62.8.679.40","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(98)90409-9"},{"key":"2025092505443873000_62.8.679.41","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800654"},{"key":"2025092505443873000_62.8.679.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2005.07.130"},{"key":"2025092505443873000_62.8.679.43","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/8.4.661"},{"issue":"(1s)","key":"2025092505443873000_62.8.679.44","first-page":"215A","article-title":"Endometrial carcinomas in women age 40 years and younger.","volume":"22","author":"Garg","year":"2009","journal-title":"Mod Pathol"},{"key":"2025092505443873000_62.8.679.45","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.18.6296"},{"key":"2025092505443873000_62.8.679.46","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31816380c4"},{"key":"2025092505443873000_62.8.679.47","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2003.12.009"},{"key":"2025092505443873000_62.8.679.48","doi-asserted-by":"publisher","DOI":"10.1097\/00004347-199207000-00003"},{"key":"2025092505443873000_62.8.679.49","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2001.6279"},{"key":"2025092505443873000_62.8.679.50","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.03.5915"},{"key":"2025092505443873000_62.8.679.51","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000213423.30880.ac"},{"key":"2025092505443873000_62.8.679.52","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20001015)89:8<1758::AID-CNCR16>3.0.CO;2-A"},{"key":"2025092505443873000_62.8.679.53","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.2107"},{"key":"2025092505443873000_62.8.679.54","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.1574"},{"key":"2025092505443873000_62.8.679.55","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052627"},{"key":"2025092505443873000_62.8.679.56","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23554"},{"key":"2025092505443873000_62.8.679.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2005.12.032"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jcp.2009.064949","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:44:51Z","timestamp":1758804291000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jcp.2009.064949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,7,28]]},"references-count":57,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2009,7,28]]},"published-print":{"date-parts":[[2009,8]]}},"alternative-id":["10.1136\/jcp.2009.064949"],"URL":"https:\/\/doi.org\/10.1136\/jcp.2009.064949","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,7,28]]}}}